SSRI Antidepressants Linked to Early Birth

Women who take antidepressants known as selective serotonin reuptake inhibitors (SSRI) during pregnancy may be more likely to experience premature birth than other women, according to a new study. The study, which was published in the Archives of Pediatrics and Adolescent Medicine, also found that babies born to women taking SSRIs were more likely to be admitted to an intensive care unit.

Popular SSRIs include Prozac, Paxil, Zoloft, Celexa, and Lexapro. SSRIs affect seratonin levels in the brain, a chemical neurotransmitter. Seratonin is produced in the brain on an ongoing basis and in response to pleasure-giving experiences, in a normally healthy system.

For this study, researchers at the Bandim Health Project in Guinea-Bissau looked at health records of more than 56,000 women who received prenatal care from the University of Aarhus Hospital between 1989 and 2006. About 300 of them had received SSRIs during their pregnancy and nearly 5,000 of the study participants had a history of psychiatric problems but did not take any SSRIs while being treated for their pregnancy.

According to the study authors, women who took SSRIs delivered their babies five days earlier than other women in the study, and were twice as likely to give birth prematurely. Babies born to these women were also more likely to have a five-minute APGAR score of seven or below. A baby considered healthy generally has a score of seven or higher. They also faced a higher risk of being admitted to the intensive care unit, and some showed signs of withdrawal.

In addition to preterm birth, SSRIs are associated with other serious side effects. Paxil, for instance, has been shown to increase the risk of heart related birth defects. In fact, on two occasions in 2005 , the Food & Drug Administration (FDA) requested that the labeling of Paxil be changed to include warnings on three studies that found an increase risk of birth defects. Most of the heart defects reported in these studies were atrial and ventricular septal defects (holes in the walls of the chambers of the heart). That same year, the FDA also classified the birth defect risk as Category D (Positive Evidence of Fetal Risk).

Babies born to mothers who have taken antidepressants, including SSRIs in the third trimester of pregnancy have suffered complications from withdrawal, including difficulties with breathing, turning blue, seizures, changing body temperature, feeding problems, vomiting, low blood sugar, floppiness, stiffness, tremor, shakiness, irritability or constant crying. In many of these cases, tube feeding, help with breathing and longer hospitalization was needed.